慢性心力衰竭患者6 min 步行试验与血清脑利钠肽水平的临床研究

中国临床药理学与治疗学 ›› 2004, Vol. 9 ›› Issue (5): 561-564.

慢性心力衰竭患者6 min 步行试验与血清脑利钠肽水平的临床研究

陈协兴, 洪华山, 陈良龙, 郑关毅¹, 王一波, 江琼, 董现锋

福建医科大学附属协和医院心内科, 福建省冠心病研究所; ¹中医科, 福州350001, 福建

收稿日期:2003-12-30 修回日期:2004-03-30 发布日期:2020-11-22
通讯作者: 陈协兴,男, 硕士, 主治医师, 研究方向:心血管病临床与基础。Tel:0591-3357896-8422 8475 E-mail:chenxiexing @medmail.com.cn
作者简介:洪华山, 男, 博士, 副教授, 硕士生导师, 研究方向:冠心病及其心肌纤维化的临床与基础。Tel:0591-3357896-8455 8475 E-mai l:honghuashan @hotmail.com

Clinical study on the six-minute walk test and serumbrain natriuretic peptide levels in patients with chronic heart failure

CHEN Xie-Xing, HONG Hua-Shan, CHEN Liang-Long, ZHENG Guan-Yi¹, WANG Yi-Bo, JIANG Qiong, DONG Xian-Feng

Department of Cardiology, UnionHospital of FujianMedical University, Fujian Institute of Coronary Heart Disease; ¹Department of Traditional Chinese Medicine, Fuzhou 350001, Fujian, China

Received:2003-12-30 Revised:2004-03-30 Published:2020-11-22

摘要/Abstract

摘要： 目的通过对慢性心力衰竭患者的6 min 步行试验(6MWT) 的距离和血清脑利钠肽(BNP) 水平的观察, 探讨6MWT 和BNP 水平对心力衰竭患者心脏功能评估的临床意义。方法测量51 例慢性心力衰竭患者(心衰组) 的6MWT 距离和酶联免疫吸附法检测血清BNP-32 浓度。并以30 例健康成人为对照组。结果心衰组的6MWT 距离380.3 ±121.7 m 明显低于对照组546.8 ±128.5 m (P <0.01)。心衰组BNP 水平758.3 ±289.5 ng·L^-1 明显高于对照组109.3 ±37.6 ng·L^-1 (P <0.01)。NYHA 心功能Ⅱ级的6MWT 距离425.0 ±105.8 m 明显低于Ⅲ 级335.6 ±126.1 m (P <0.01)。NYHA Ⅱ级的BNP 水平638.5 ±224.5 ng·L^-1 明显高于Ⅲ 级878.0 ±334.0 ng·L^-1 (P <0.01)。6MWT 距离<300、300 ~374.9、375 ~ 449.9 和<450 m 患者的BNP 水平分别为988.9 ±202.6、768.6 ±217.4、657.5 ±185.0 和506.9 ±198.4 ng·L^-1 (P <0.01);6MWT 的距离与BNP 水平呈负相关(r=-0.752, P <0.01)。结论 6MWT 和BNP 水平测定对慢性心力衰竭患者的心脏功能评估具有重要临床意义。

关键词: 心力衰竭, 6分钟步行试验, 利钠肽, 脑, 诊断, 心脏功能评估

Abstract: AIM: To investigate clinical significance of Six-Minute Walk Test (6MWT) and serum brain natriuretic peptide (BNP) levels in evaluating heart function in patients with chronic heart failure (CHF). METHODS: 51 patients with CHF (CHF group) and 30 healthy subjects served as control group were involved in the trials.The distance walked in six-minute and the serum levels of BNP-32 by enzyme-linked immunosorbent assay method were observed.The differences among 6MWT distance, BNP levels and different NYHA classes were analysed. RESULTS: The 6MWT distances in CHF group and control group were 380.3 ±121.7 and 546.8 ± 128.5 m, respectively (P <0.01).The serum levels of BNP in CHF group and control group were 758.3 ±289.5 and 109.3 ±37.6 ng·L^-1, respectively (P <0.01). The 6MWT distances in NYHA class Ⅱand Ⅲ of CHF patients were 425.0 ±105.8 and 335.6 ±126.1 m, respectively (P <0.01).The BNP levels in NYHA class Ⅱ and Ⅲ of CHF patients were 638.5 ±224.5 and 878.0±334.0 ng·L^-1, respectively (P <0.01).BNP levels in CHF patients of 6MWT distances among below 300, 300-374.9, 375-449.9 and above 450 m was 988.9 ±202.6, 768.6 ±217.4, 657.5 ±185.0 and 506.9 ±198.4 ng·L^-1, respectively (P <0.01).The 6MWT distance was inversely correlated to the BNP level (r=-0.752, P <0.01). CONCLUSION: Not only 6MWT distances but also serum BNP levels have an important clinical value in evaluating heart function of CHF.

Key words: heart failure, six-minute walk test, brain natriuretic peptide, diagnosis, heart function evaluation

中图分类号:

R514.61

陈协兴, 洪华山, 陈良龙, 郑关毅, 王一波, 江琼, 董现锋. 慢性心力衰竭患者6 min 步行试验与血清脑利钠肽水平的临床研究[J]. 中国临床药理学与治疗学, 2004, 9(5): 561-564.

CHEN Xie-Xing, HONG Hua-Shan, CHEN Liang-Long, ZHENG Guan-Yi1, WANG Yi-Bo, JIANG Qiong, DONG Xian-Feng. Clinical study on the six-minute walk test and serumbrain natriuretic peptide levels in patients with chronic heart failure[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2004, 9(5): 561-564.

参考文献

1 中华医学会心血管病分会, 中华心血管病杂志编辑委员会.慢性收缩性心力衰竭治疗建议[J].中华心血管病杂志, 2002;30(1):7-23
2 Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al.Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure[J].N Engl J Med, 2002;347(3):161-7
3 Harrison A, Morrison LK, Krishnaswamy P, Kazanegra R, Clopton P, Dao Q, et al.B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea[J].Ann Emerg Med, 2002;39(2):131-8
4 陈协兴, 洪华山, 王一波, 江琼, 董现锋, 陈良龙.慢性心力衰竭患者血清脑利钠肽水平的变化及其临床意义[J].中国临床药理学与治疗学, 2003;8(6):631-4
5 陈协兴, 洪华山, 王一波, 江琼, 陈良龙.脑钠素在慢性心力衰竭诊断、预后评估中的价值[J].中国循环杂志,2003;18(6):434-6
6 Guy att GH, Sullivan MJ, Thompson PJ, Fallen EL, Pugsley SO, Taylor DW, et al.The 6-minute walk:a new measure of exercise capacity in patients with chronic heart failure[J].Can Med Assoc, 1985;132(8):919-23
7 Bittner V, Weiner DH, Yusuf S, Rogers WJ, McIntyre KM, Bangdiwala SI, et al.Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investigtors[J].JAMA, 1993;270(14):1702-7
8 Peeters P, Mets T.The 6-minute walk as appropriate exercise test in elderly patients with chronic heart failure[J].Gerontol A Biol Sci, 1996;51(4):M147-51
9 Cahalin LP, Mathier MA, Semigran MJ, Dec GW, DiSalvo TG.The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure[J].Chest, 1996;110(2):325-32
10 Mcdonagh TA, Robb SD, Murdoch DR, Morton JJ, Ford I, Morrison CE, et al.Biochemical detection of left ventricular systolic dysfunction[J].Lancet, 1998;351(9095):9-13
11 Maisel A.B-type natriuretic peptide levels:diagnostic and prognostic in congestive heart failure[J].Circulation, 2002; 105(20):2328-31
12 杨跃进, 郭静萱.2002 年欧洲心力衰竭专题研讨会亮点介绍[J].中国循环杂志, 2002;17(4):319-20
13 Shah MR, Hasselblad V, Gheorghiade M, Adams KF, Swedberg K, Califf RM, et al.Prognostic usefulness of six-minute walk in patients with advanced congestive heart failure secondary to ischemic or nonischemic cardiomyopathy[J].Am J Cardiol, 2001;88(9):987-93

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